CPT® Code 93153

1. Indications

The procedure associated with CPT® Code 93153 is indicated for patients who have a previously implanted phrenic nerve stimulator system and are experiencing changes in their condition or symptoms related to central sleep apnea. The interrogation is performed to evaluate the device's performance and ensure it is functioning optimally in response to the patient's needs. This may include assessing the effectiveness of the stimulation settings and determining if any further adjustments are necessary based on the patient's feedback and clinical observations.

• Central Sleep Apnea Patients diagnosed with central sleep apnea who have undergone implantation of a phrenic nerve stimulator system.
• Changes in Efficacy Patients experiencing recent changes in the effectiveness of their phrenic nerve stimulation therapy.
• New Symptoms Patients presenting with new symptoms that may indicate a need for evaluation of the implanted device's performance.

2. Procedure

The procedure for CPT® Code 93153 involves several key steps to ensure a comprehensive interrogation of the implanted phrenic nerve stimulator system. Each step is crucial for gathering the necessary data to assess the device's functionality.

• Step 1: Patient Positioning The patient is positioned in various sleeping postures, including supine, left side, and right side. This positioning is essential to evaluate how the device performs under different conditions, as the effectiveness of stimulation may vary based on the patient's position during sleep.
• Step 2: Device Interrogation The pulse generator of the phrenic nerve stimulator is interrogated to collect data on several parameters. This includes measuring the rate of stimulation, pulse amplitude, duration, and timing of stimulation. These parameters are critical for understanding how the device is functioning and whether it is providing adequate therapy for the patient.
• Step 3: Functionality Assessment The interrogation process also involves assessing the battery status and the functionality of the electrode(s). This step ensures that the device is operational and that the electrodes are effectively delivering stimulation to the phrenic nerve.
• Step 4: Compliance and Output Evaluation The output cycling and impedance of the device are measured, along with an evaluation of patient compliance. This information is vital for determining whether the patient is adhering to the therapy and if the device is performing as expected.
• Step 5: Patient Feedback The patient's input is solicited regarding their perception of how well the current settings are working. This subjective feedback is important for understanding the patient's experience and satisfaction with the therapy.
• Step 6: Discussion of Findings Finally, the results of the interrogation are discussed with the patient. This includes any findings related to the device's performance and the potential need for further adjustments or follow-up monitoring to optimize therapy.

3. Post-Procedure

After the interrogation procedure associated with CPT® Code 93153, the patient may be advised on the next steps based on the findings. This may include scheduling follow-up appointments for further monitoring or adjustments if necessary. The healthcare provider will discuss the results of the interrogation with the patient, emphasizing any changes in the device's performance and the importance of ongoing compliance with therapy. The patient may also be instructed to report any new symptoms or concerns that arise following the interrogation, ensuring that their treatment remains effective and responsive to their needs.